A case report of endocarditis after tongue piercing is presented. Body piercing is a form of self-expression that is achieving greater acceptance and wider practice in modern society. Even in healthy individuals, significant health risks exist with this type of physical adornment. Despite this fact, no significant regulatory mechanisms are currently in place to guide practitioners of this craft or to protect the recipients of body piercing. Medical professionals should join the American Dental Association in their opposition of the practice of intraoral/perioral piercing and should call for the development of legislation protecting the recipients of such practices, particularly the population of young people in whom this type of body art is becoming increasingly prevalent.